Combined laparoscopic uterosacral and round ligament procedures for treatment of symptomatic uterine retroversion and mild uterine decensus

Study Objective. To evaluate the efficacy of a new modified technique to treat a symptomatic retrodisplaced uterus. Design. Prospective clinical study (Canadian Task Force classification 11-2). Setting. Tertiary care university hospital. Patients. Thirty-one women with symptomatic uterine retrodisplacement but without significant pelvic pathology. Intervention. Laparoscopic shortening and plication of uterosacral ligaments with modified Gilliam suspension. Measurements and Main Results. In average follow-up of 3.3 ± 1.0 years, all patients had an anteverted, anteflexed uterus. Mean ± SD operating time was 24.1 ± 4.7 minutes. There were no complications during or after surgery, Dyspareunia scores before and after surgery were 5.4 ± 1.4 and 0.5 ± 0.7, respectively (p <0.001). Chronic pelvic pain was satisfactorily relieved in seven of nine women. Vagina lengths before and after surgery were 5.9 ± 0.7 and 7.0 ± 0.3 cm, respectively (p <0.001). Conclusion. Our technique achieved long-lasting good results in suspending uteri in anteverted, anteflexed position and relieved symptoms caused by retrodisplacement.